[Question #3423] Testing

37 months ago
Hello

I am needing some advice please. I have had several sexual encounters with guys over the past few weeks and have had oral sex where I was the insertive partner, anal sex where I was the insertive partner and used a condom, and have kissed each of them. To my knowledge the condoms did not break but can’t be sure.  My questions are this:

1) I am wanting to take the early detection RNA test and the lab I am using says it’s 100% conclusive after 14 days. Is that true?  I have read on line it’s not that accurate. 
2) does this test become “inaccurate” after 6 weeks or is it also accurate after 14 days?
3) should I wait and take the hiv generation 4 test at 4 weeks? 

I want to take the most accurate test that will give me the most accurate result the fastest regardless of how much it cost. 

Thanks 
H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
Welcome to the forum and thanks for your question. I happened to log in a couple of minutes after you posted it:  most users shouldn't expect nearly real time replies!

Congratulations for an obviously safe approach to your sexual experiences with other men. The chance is extremely low you caught HIV during any of these encounters. There have been few or know scientifically proved HIV transmissions by kissing or by oral sex from mouth to penis (and only rare transmissions penis to mouth). Insertive anal sex is the single highest risk sexual practice, but condoms are extremely effective if they don't obviously rupture -- and that's very unlikely if you didn't notice it happening.

The DNA/RNA detection tests aren't quite 100% conclusive at 2 weeks; they're generally considered 90-95% reliable at that time. Even though you don't care about cost, I still see no reason to spend money unnecssarily. Have an antigen-antibody (4th generation) test 6 weeks after the last exposure (4 weeks isn't quite conclusive, about 98-99% reliable at that time). Or if you decide to spend the big bucks on a DNA/RNA test at 2 weeks, then add an AgAb test or a 3rd generation antibody test at 4 weeks; that combination will be conclusive.

For all these tests, once positive they all remain positive for life. No test ever becomes negative once it is positive.

One final thought about safer sex:  If you're not routinely discussing mutual HIV status with partners before sex, I suggest you add it to your safe sex repertoir, in addition to condoms for anal sex -- and avoid anal sex, even with condoms, with those who are positive and not on treatment and/or have high viral loads, as well as those who don't know or are evasive about it. People usually know these things about themselves and most don't lie when asked directly, so this is an important and effective component of safer sex among men.

I hope this information is helpful. Let me know if anything isn't clear.

HHH, MD

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37 months ago
Ok thanks. So I have read several posts on here where you both have said that kissing and having your penis sucked where no risk events. It’s appears now you are saying that there is a small risk. Is that correct?


H. Hunter Handsfield, MD
H. Hunter Handsfield, MD
37 months ago
I'm afraid you're splitting hairs. Nobody can prove that such exposure can never transmit HIV. But since there have been no proved cases, the risk can be consdidered zero for all practical purposes. There is no intended difference, nor should any forum user assume there is, between such terms as "no risk", "zero risk", "no risk for practical purposes", "few or no cases", and so on. (Forgive my typo above:  no, not know.)---